Mayo Clinic 'Model' at Center of Health Care Debate

Photo: Mayo Clinic Model at Center of Health Care Debate: Fewer Tests, Fixed Salaries for Doctors, Collaboration Cited for Clinics Strong Results

Dr. Mike Wilson's favorite way to calm his nerves is to play the piano. And on the eve of a new job at the Mayo Clinic in Rochester, Minn., Wilson found himself eager to play.

"So tomorrow night is my first long call, that's where you get to stay all night at the hospital," Wilson, who was part of a group of incoming internists, told ABC News in a recent interview. "I've done it a couple of times in medical school. I guess the difference is that this is first time you are responsible for the decision you make, you write the orders and you have the final say."

Wilson was preparing for his new job at a time when the entire field of medicine is being rocked by a debate over the government's role in providing health care. And one of the primary exhibits in that debate is the hospital he was about to join.

The Presidents Best Hospital

President Barack Obama frequently singles out the Mayo Clinic as an example of quality, cost-effective health care.

"The Mayo Clinic in Rochester, Minn., is famous for some of the best quality and some of the lowest cost," Obama said in a June speech. "People are healthier coming out of there, they do great."

Over the next three years Wilson and other new internists will be steeped in what some people say is a radically different approach to doing medicine. A lot of experts are convinced that the Mayo model -- in which patient tests are minimized, doctor salaries are fixed, records are electronic and groups of doctors work together -- proves that health care reform isn't about who pays for care, but about how it is given.

At stake in the debate is the role of insurance companies, how much care will cost, doctors' incomes and, ultimately, the well-being of the patient.

Slyvia Jaramillo is with Wilson in the incoming class of Mayo internists.

"I think it's exciting," she said of the health care debate. "I think it's, that's what makes it an exciting time to be in, you know, in medicine."

Wilson said the debate still had a lot of life in it.

"I think we need to keep talking about it," he said. "And I think it's finally come to the point where we realize something has to be done about this health care system."

'The Answer Is in the History'

While Americans like to believe more means better, a Dartmouth University study found that with Mayo, fewer tests and procedures has meant better-quality care.

Dr. Farrell Lloyd guides new doctors through the Mayo method.

"Concentrate on the patients symptoms," Lloyd advises the new doctors. "There are lots and lots of tests we can order. You know how I always say simplify? Only order a test if a patient is having a problem. ... If you start ordering tests for the potential that something might happen, you start really getting in a difficult cycle."

The cost of a test at Mayo is comparable to a test anywhere else. But the Dartmouth study found that Mayo reduced overall costs by performing only tests doctors deemed absolutely necessary.

"If you are ordering the right tests instead of ordering the wrong tests until you get to the right tests," Lloyd said, "we actually may reduce our cost."

Wilson and Jaramillo took the lesson to heart.

"Every test in the book does not equal improved health," Wilson said. "I think I came to Mayo thinking we would order every single test, on every single patient, and we'd find out the answer."

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